As the state scrambles to beef up treatment options for heroin users following a recent surge in overdoses, some doctors worry that new legislation could actually leave many addicts in the lurch.

"As written, this could dramatically reduce access to care for patients," Dr. Jacquelyn Starer, president of the Massachusetts Society of Addiction Medicine, said of a proposed bill that seeks to put more oversight on doctors prescribing the heroin treatment drug buprenorphine.

Buprenorphine, commonly known as "bupe," is the main ingredient in the drug Suboxone, which is hailed by many doctors and patients as revolutionary.

Unlike other methods of treatment, including methadone, "bupe" is what's called a "partial agonist." It doesn't give addicts a high, reducing the possibility of life-threatening overdoses.

Approved in 2002, Suboxone was the first drug addicts could have prescribed by a doctor in an office. That appealed to many addicts from suburban or professional backgrounds - people who didn't want the stigma of attending methadone clinics, which require daily oral treatment.

"I am without a doubt certain that if I didn't have Suboxone, I would be dead today," "Maryann," a retirement-aged recovering addict from Worcester told The Daily News Wednesday at her doctor's office in Natick.

That's why Starer and other doctors say they're concerned about House Bill 907, a measure that would charge the Department of Public Health with instituting strict regulations and procedures overseeing private doctors who dispense the drug.

"It just complicates everything," Starer said of the legislation, which has already passed the state Senate and is in a third reading in the House.

The bill would give the DPH latitude to determine the level of regulation needed – something Starer and other doctors believe could ultimately curtail the availability of Suboxone.

"Most doctors, if it's just a small part of their practice, will say, ‘That's not worth it to me,'" said Starer, noting doctors are already regulated by the U.S. Drug Enforcement Agency and are restricted to 100 patients.

Starer said if some doctors pull out of the business, that could create a shortage of prescribers – a devastating prospect for people who aren't willing to go to methadone clinics.

"There would be more people without treatment, and the state would have a larger problem," Starer said.

As it stands, Massachusetts already has a shortage of inpatient treatment beds, experts say, and state funding for treatment, despite recent increases, still isn't keeping up with demand.

According to the U.S. Substance Abuse and Mental Health Services Administration, Massachusetts in 2011 had more people treated for heroin addiction than for alcoholism. Massachusetts was one of only two states in the 48-state survey to report such rampant problems with heroin addiciton.

Page 2 of 3 - In 2012, 42,308 people in Massachusetts were admitted for heroin abuse treatment, more than the number admitted for alcoholism, cocaine and marijuana addiction combined.

According to the Administration website, there are 602 doctors and 72 treatment programs in the state that administer "bupe."

Twenty-four of those doctors are in the MetroWest and Milford areas, the records show, with Spectrum Health Systems operating the only two treatment centers.

While Framingham has the highest number of doctors prescribing the drug – seven - providers are sprinkled throughout the region, including Southborough, Wayland and Weston.

"It's an epidemic," said psychiatrist Richard Goldbaum, one of five doctors licensed to prescribe the drug in Natick.

Tucked into a modest building on Pine Street, Golbaum's patients – professionals, parents, nurses – all want to keep their addictions private.

"Maryann" is one of his patients. She has struggled with heroin addiction since she first tried opium as a single mother of two in the late 1960s.

"I wound up on Back Bay on a street corner passing a bottle of wine around," she said, prostituting to get her next fix.

Family took away her kids. It took her years to get clean, and when she did, she married and got a steady job. But she relapsed in 2000, and didn't end up recovering until she found Goldbaum and Suboxone in 2005.

"Now I can babysit my grandkids," she said. " I have my life back."

While Suboxone is primarily prescribed in private, methadone – a different heroin treatment that's been around much longer – is administered daily in clinics.

Spectrum Health Services Inc., a nonprofit, provides the largest number of treatment options in this area, with locations in Framingham, Westborough and Milford.

Kristin Nolan, the company's executive director of outpatient services, said Spectrum provides both methadone and Suboxone.

She said the average outpatient treatment cost $5,500 out-of-pocket for a user per year for those with insurance. Those who can't afford to pay aren't turned away, she said, as their treatment costs are reimbursed by the state.

The state is also increasingly burdened with treatment demand through Section 35, a provision that allows family members of an individual with an addiction to have that person involuntarily committed by a judge to an addiction center on the state's dime.

"People are really at a loss when they get to this point," said Kerri Quintal, a North Attleboro attorney who has assisted families in Section 35 commitments for more than 15 years.

Quintal said though the idea seems like a cheap way to get treatment, it can backfire.

"There's only so many spots," she said, and sometimes a bed can't be found.

The state maintains less than 200 beds for people committed under the section, which causes addicts sometimes to be sent to jail if a bed isn't available.

Page 3 of 3 - Released Wednesday, the House Ways and Means budget would add 64 treatment beds statewide. While that will help, some experts say the most important arena that needs improvement is psychiatric care for those with addictions.

‘The one thing I think is the common of all recovered addicts is they have a psychological component of care," said Mark Kinchla, director of substance abuse for the South Middlesex Opportunity Council. "There is some relationship they've established with a caregiver that is important to them. They feel valued."

Starer agreed, saying she believes responsible outpatient treatment reduces the need for inpatient beds. That's why she said she and other organizations – including the Massachusetts Medical Society – oppose the House bill to increase regulation of Suboxone prescribers.

Golbaum said he believes state legislators, instead of going after Suboxone doctors, should work to curb over-prescription of opioid pain medications like Percoset and Oxycontin.

It's addiction to those medications, he said, that often leads people to try heroin for the first time, and can lead to death if they come across a strain laced with fentanyl, a painkiller 10 times as strong as morphine.

Starer said insurance is also a concern because those people sometimes wait months for treatment because of backwards referral requirements.

"It needs to be considered a medical emergency when somebody wants to get treatment," she said.

State Sen. Ben Downing, who brought forth the Suboxone bill, said Thursday he is aware of the concerns and is working with the Society of Addiction Medicine and other opponents to address them.

The Pittsfield Democrat said some increased level of oversight is needed, noting that one unscrupulous prescriber in his district led to Suboxone being used "everywhere," including in schools.

"I think unfortunately, some have seen it simply as a way to make a quick buck, or have not fully understood the need to support the drug treatment with other services," he said.

Downing said he will work to modify the bill so it has more widespread support. He said it is not his intention to decrease the number of doctors legitimately prescribing Suboxone.

"We're trying to come up with solutions on the fly," he said. "I think we all hope we'd had these solutions in place four or five years ago, but we're going to have to work together."

Brad Petrishen can be reached at 508-490-7463 or bpetrishen@wickedlocal.com. Follow him on Twitter @BPetrishen_MWDN.